Diagnosis | Stanford Health Care

Skip to main content Notice: Users may be experiencing issues with displaying some pages on stanfordhealthcare.org. We are working closely with our technical teams to resolve the issue as quickly as possible. Thank you for your patience.  

See our updated masking policy

Menu Search Menu Search Home Close Doctors Clinics & Locations Conditions & Treatments Clinical Trials MyHealth Login Patients & Visitors Billing Insurance Financial Assistance Medical Records Contact Us Video Visits Get a Second Opinion COVID-19 Resource Center Healthcare Professionals Referring Physicians Nursing Allied Healthcare About Us Quality & Safety Facilities Services & Planning Sustainability Careers Newsroom Make a Donation Stanford Health Care – Now

• Doctors & Providers
• Clinics & Locations
• Conditions & Treatments
• Patients & Visitors
• MyHealth

• Billing
• Insurance
• Medical Records
• Support Groups
• Help Paying Your Bill
• COVID-19 Resource Center
• Community Health

• Locations and Parking
• Visitor Policy
• Hospital Check-in
• Video Visits
• International Patients
• Contact Us

View All Information for Patients & Visitors We are available to assist you 24/7. 650-498-3333 [email protected]

View the changes to our visitor policy

 

View information for Guest Services

New to MyHealth?

Manage Your Care From Anywhere.

Access your health information from any device with MyHealth.  You can message your clinic, view lab results, schedule an appointment, and pay your bill.

ALREADY HAVE AN ACCESS CODE?

Activate Account

DON'T HAVE AN ACCESS CODE?

Create a New Account

NEED MORE DETAILS?

Learn More about MyHealth Learn More about Video Visits

MyHealth for Mobile

Get the iPhone MyHealth app Get the Android MyHealth app

WELCOME BACK

Forgot Username or Password? Need Help? Clear Diagnosis

How We Can Help You for Ankylosing Spondylitis

The doctors in the Stanford Medicine Spine Center have the experience needed to accurately diagnose and effectively treat ankylosing spondylitis (pronounced "an-kil-OH-sing spawn-duh-LY-tus" and also known as “AS”).

We help relieve symptoms, which may include pain and stiffness in the neck, shoulders, back, buttocks, chest, and other areas of the body. We also help manage complications of AS such as fatigue, anemia, and uveitis (inflammation of the eye).

Stanford Medicine Spine Center patients with AS also may have opportunities to participate in research studies of new treatment approaches not yet available anywhere else.

Find a Doctor or Provider Make an Appointment View Locations

What We Offer You for Ankylosing Spondylitis

• Center of Excellence for advanced care of spine-related conditions.
• Nationally recognized expertise in treating every type of AS, no matter how complex.
• Precise diagnosis options including the latest imaging technology.
• Team-based treatment planning that brings together orthopaedic surgeons, neurologists and neurosurgeons, pain management specialists, rheumatologists, physiatrists, geneticists, and others to tailor care to your needs.

• Advanced treatment options emphasizing noninvasive approaches whenever possible, including exercises, physical therapy, and medication therapy, and, when needed, spine surgery.
• Comprehensive support services including care coordination from diagnosis to treatment to follow-up.
• Active research program to develop new diagnostic and treatment advances.

Treatments for Ankylosing Spondylitis

The team members of the Stanford Medicine Spine Center use the most advanced techniques to effectively treat AS. We have experience with all treatment approaches and use minimally invasive techniques whenever possible.

Our team includes doctors from orthopaedics, neurology, rheumatology, physiatry, and other specialties, working together to help ensure you receive an accurate diagnosis and the most effective treatment possible.

Our team develops an AS care plan that is personalized to your unique needs.

tabs false

Our AS treatments focus on:

• Reducing pain, stiffness, and inflammation
• Keeping your condition from getting worse
• Helping you continue or resume doing your daily activities

Early, precise diagnosis and treatment may help reduce symptoms. Timely treatment also may reduce the risk of AS causing deformity to your spine or back.

Starting Treatment

Continuing Treatment

Other Treatments

• AS treatment may begin with nonsteroidal anti-inflammatory drugs (NSAIDs). They can relieve pain and stiffness, and reduce inflammation.
• Flexibility and strengthening exercises can help you stay mobile and manage your pain.
• Physical therapy is designed to help you keep a good posture and also to build your lung capacity through breathing exercises.
• Devices such as canes and walkers can help you continue being physically active while reducing stress on your joints.

If your first treatment does not relieve your pain and inflammation, your doctor may recommend an approach that includes one or more of the following:

• Corticosteroids (also called epidural steroid injection) to help reduce inflammation
• Disease-modifying antirheumatic drugs (DMARDs) to reduce pain and inflammation in joints other than the spine and pelvis
• Treatment of complications that may occur—for example, eye inflammation (uveitis or iritis) may be treated with special eye drops

In some cases, surgery may be required to replace severely damaged joints—most commonly, hip replacement.

We perform spinal surgery for AS, but only when absolutely needed. For example, if there is loosening of vertebrae in the neck and signs of spinal pressure, such as numbness in the hands, we may recommend permanently fusing the two vertebrae together.

We also may perform surgery to treat curvature of the spine.

Starting Treatment

• AS treatment may begin with nonsteroidal anti-inflammatory drugs (NSAIDs). They can relieve pain and stiffness, and reduce inflammation.
• Flexibility and strengthening exercises can help you stay mobile and manage your pain.
• Physical therapy is designed to help you keep a good posture and also to build your lung capacity through breathing exercises.
• Devices such as canes and walkers can help you continue being physically active while reducing stress on your joints.

close Starting Treatment Continuing Treatment

If your first treatment does not relieve your pain and inflammation, your doctor may recommend an approach that includes one or more of the following:

• Corticosteroids (also called epidural steroid injection) to help reduce inflammation
• Disease-modifying antirheumatic drugs (DMARDs) to reduce pain and inflammation in joints other than the spine and pelvis
• Treatment of complications that may occur—for example, eye inflammation (uveitis or iritis) may be treated with special eye drops

close Continuing Treatment Other Treatments

In some cases, surgery may be required to replace severely damaged joints—most commonly, hip replacement.

We perform spinal surgery for AS, but only when absolutely needed. For example, if there is loosening of vertebrae in the neck and signs of spinal pressure, such as numbness in the hands, we may recommend permanently fusing the two vertebrae together.

We also may perform surgery to treat curvature of the spine.

close Other Treatments

Interested in an Online Second Opinion?

The Stanford Medicine Online Second Opinion program offers you easy access to our world-class doctors. It’s all done remotely, and you don’t have to visit our hospital or one of our clinics for this service. You don’t even need to leave home!

Visit our online second opinion page to learn more.

Clinical Trials

0

Open Clinical Trials

View All

Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest clinical trials.

Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future.

Closed trials are not currently enrolling, but may open in the future.

What Is Ankylosing Spondylitis?

Overview Symptoms Causes Types Diagnosis Risk Factors Overview Symptoms Causes Types Diagnosis Risk Factors

Diagnosis of Ankylosing Spondylitis

Your doctor will use your medical history, a physical exam, and an X-ray to diagnose AS.

By asking questions about your medical history, your doctor can evaluate your symptoms. Most people with AS have back pain with four or all of the following characteristics: 

• Pain starts before the age of about 35
• It starts and gets worse gradually 
• It lasts for at least 3 months 
• The pain is linked with morning stiffness that usually lasts for more than 1 hour 
• The pain improves with exercise

The clearest sign of the disease is a change in the sacroiliac joints at the base of the low back. This change can take up to a few years to show up on an X-ray. 

Your doctor will want to know if you have any family members who have AS or a related joint disease. Many people with AS have a family member with the same condition. The doctor may also ask if you've had ongoing diarrhea, belly pain, multiple infections of the cervix (in women) or urethra (more common in men), psoriasis, or inflammation of the eye chamber (uveitis). These could be clues to having a condition other than AS. 

You will have a physical exam to see how stiff your back is and whether you can expand your chest normally. Your doctor will also look for tender areas, especially over the points of the spine, the pelvis, the areas where your ribs join your breastbone, and your heels. You may have chest pain and stiffness. 

Tests related to ankylosing spondylitis include: 

• X-rays of the spine and pelvis. These tests can check for bone changes (bony erosions, fusion, or calcification of the spine and sacroiliac joints). Certain changes in the sacroiliac joint confirm the diagnosis of AS. But those changes can take several years to develop enough to show on an X-ray.
• Magnetic resonance imaging (MRI) and computed tomography (CT) scan are more sensitive than X-ray. If no changes to the sacroiliac joints show on the X-ray but your doctor still suspects AS, an MRI or CT scan may allow an earlier diagnosis.
• Ultrasound is being studied as a way to diagnose ankylosing spondylitis earlier. 
• Blood tests may include: 
• C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR), also called “sed rate,” to look for inflammation
• Rheumatoid factor or antinuclear antibody test (ANA) to look for other types of arthritis or illness 
• A genetic test may help show if you have a gene (HLA-B27) often linked with AS. Many people who have the HLA-B27 gene won't get AS. So, having this test won't confirm that you have the condition. But the test results can be helpful if your symptoms and physical exam haven't pointed to a clear diagnosis

Previous Section Next Section Our Clinics Stanford Medicine Spine Center

The Stanford Medicine Spine Center is staffed by world-class spine specialists from neurosurgery and orthopaedics, who work together to offer you the world’s most advanced and effective treatment options—including those that don’t involve surgery. Our goal is to safely get you back to your normal lifestyle as soon as possible, and maintain long-term spinal health.

Stanford Medicine Spine Center View All Locations MAKE AN APPOINTMENT FIND A DOCTOR OR PROVIDER Make An Appointment

To schedule an appointment, please call 650-725-1125.

Close Share on Facebook Share on X Share via email Close Open Close Open Close Open Close Open Share on Facebook X (Twitter) Email